IPAB: The Acronym for Death Panels

The socialist remnants of Britain have the Orwellian NICE (National Institute for Health and Clinical Excellence) to determine who gets medical care and who doesn’t. As ObamaCare congeals, we’ll find ourselves living or dying at the whims of IPAB:

In his speech on the deficit, Obama pointed to IPAB [Independent Payment Advisory Board] as an answer to Paul Ryan’s plan. In Ryan’s vision, competition among insurers will force efficiencies and lower prices. Under Obama’s plan, in contrast, health-care prices for the elderly would be controlled by IPAB. Ryan’s plan puts consumers in the driver’s seat, but also exposes them to the risk of bad choices and limited subsidies. While Obama’s plan offers government-guaranteed care, IPAB’s price controls will lead to one-size-fits-all rationing. As IPAB caps Medicare payments for various services, the elderly will be unable to obtain many kinds of care, or will experience de facto rationing via long treatment delays and sharp declines in the quality of care. And by the way, IPAB rationing will hit many current seniors, whereas Ryan’s reform of Medicare will never affect anyone now 55 or older.

But that’s not the worst of it. IPAB will be key to implementing Obamunists’ goal, Stalinization of the healthcare system. James Capretta is on to them.

Their goal, says Capretta, is to work by stealth, so voters never fully realize that the government has adopted their strategy. The first part of the plan involves taxing “the rich” for Medicare and health insurance, but without Reagan-style indexing of taxes to inflation. That way, inflation-driven “bracket creep” will raise health-care taxes on the middle class without congressional Democrats ever having to vote for new taxes.

The second part of the plan involves IPAB-imposed price controls and the large-scale rationing of health care that implies. But to work, IPAB’s authority has got to extend beyond Medicare. The idea, says Capretta, is to wait until the massive financial strains brought on by Obamacare bring calls for cost control. That’s when the Democrats will push for IPAB’s authority to be extended beyond Medicare to all of Obamacare, at which point we’ll be very close to a single-payer health-care system with Canadian-style rationing.

The president’s speech last week tracks well with Capretta’s predictions. Obama promised tax hikes for “the rich,” and vaguely alluded to plans to expand IPAB’s powers as deficits mount. Of course, even as he laid the groundwork for strengthening IPAB, Obama gave no real hint of the massive health-care rationing that would imply. And at the moment, the Congressional Budget Office predicts little or no savings from IPAB’s price-setting, so Obama’s speech came off as an unserious reply to Ryan. But as Mark Hemingway points out, Obama’s IPAB plan makes sense if we see it as “a Trojan horse” for a regime of “command-and-control rationing” quietly installed over the long term.

The Manchurian Moonbat can never lay out his true objectives, because at this point we still have guns and elections, and only a tiny minority of Americans are Marxists who would approve of what he’s doing to our country if they understood it. But despite the smokescreen perpetually maintained by his collaborators in the “mainstream” media, you don’t have to look hard to see what he’s up to.

Michael Ledeen and PJ O’Rourke agree: the secret to understanding Obama is that he is typical politically correct apple-polishing teacher’s pet of a student that was insufferable in school, and remains so today.